Malignant lymphoma, intermediate lymphocytic type: a clinicopathologic study of 42 cases.
Malignant lymphoma, intermediate lymphocytic type: a clinicopathologic study of 42 cases.
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中间淋巴细胞型恶性淋巴瘤42例临床病理研究。
DOI：
10.1002/1097-0142(19810915)48:6
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发表时间：
1981
期刊：
影响因子：
6.2
通讯作者：
Rappaport,H
中科院分区：
文献类型：
--
作者：
Weisenburger,DD;Nathwani,BN;Diamond,LW;Winberg,CD;Rappaport,H
本文对42例介于高分化（WDLL）和低分化淋巴细胞淋巴瘤（PDLL）之间的中间淋巴细胞型（ILL）非霍奇金淋巴瘤的临床病理分析。在淋巴结切片中，ILL的特征是弥漫性增生，主要由小淋巴样细胞组成，细胞核略不规则或凹陷。细胞核完全圆形的淋巴样细胞和细胞核呈角状和裂形的淋巴样细胞的混合也存在，但这两种细胞群各占总细胞群的比例不超过30%。患者的中位年龄为65岁，男女比例为5:1。74%的患者有明显的全身性淋巴结病变，36%的患者有B型症状。21%的患者发病时外周血受累，76%的患者被淋巴瘤累及骨髓。5%的患者患有I期疾病，24%患有III期疾病，71%患有IV期疾病。93%的患者接受了多药化疗，41%的患者完全缓解。总中位生存期为31个月。可能对生存产生不利影响的临床特征包括B症状（P= 0.007）、年龄大于70岁（P= 0.09）、绝对淋巴细胞计数高于5000/mm3（P= 0.05）和贫血（P= 0.09）。达到完全缓解有利于生存（P= 0.02）。影响生存的病理特征包括对生存不利的鼻窦闭塞（P= 0.05）和对生存有利的生发中心残留（P= 0.06）。0-5个有丝分裂/10个高倍视野（HPF）患者的生存期明显长于20个/10个高倍视野（HPF）患者（P= 0.02），而6-20个/10个高倍视野（HPF）患者的生存期中等。ILL患者的临床和病理特征提示该实体与PDLL密切相关，应与WDLL区分开来。
A clinicopathologic analysis of 42 cases of non‐Hodgkin's lymphoma of the intermediate lymphocytic type (ILL) having morphologic features between those of well‐differentiated (WDLL) and poorly differentiated lymphocytic lymphoma (PDLL) is presented. In lymph node sections, ILL was characterized by a diffuse proliferation consisting predominantly of small lymphoid cells with slightly irregular or indented nuclei. A mixture of lymphoid cells with entirely round nuclei and lymphoid cells with angulated and cleaved nuclei was also present, but each of these two cell populations did not comprise more than 30% of the total. The median age of the patients was 65 years, and the male‐to‐female ratio was 5:1. Generalized lymphadenopathy was evident in 74% of the patients, and B symptoms were presented in 36%. Peripheral blood involvement was present at the onset of disease in 21% of the patients, and the bone marrow was involved by lymphoma in 76% of those examined. Five percent of the patients had Stage I disease, 24% had Stage III disease, and 71% had Stage IV disease. Ninety‐three percent of the patients received multiagent chemotherapy and 41% achieved a complete remission. The overall median survival was 31 months. Clinical features which appeared to influence survival adversely included the presence of B symptoms (P= 0.007), age greater than 70 years (P= 0.09), an absolute lymphocyte count above 5000/mm3(P= 0.05), and anemia (P= 0.09). Achievement of a complete remission influenced survival favorably (P= 0.02). Pathologic features which appeared to influence survival included sinus obliteration, which had an adverse effect (P= 0.05), and the presence of residual germinal centers which had a favorable effect (P= 0.06). Patients with 0–5 mitoses/10 high power fields (HPF) had a significantly longer survival than those with more than 20 mitoses/10 HPF (P= 0.02), while those with 6–20 mitoses/10 HPF had an intermediate survival. The clinical and pathological features of patients with ILL suggest that this entity is closely related to PDLL and should be distinguished from WDLL.